SCREENING OF DIABETIC ANGIOPATHY: A PAEDIATRIC PROBLEM

Key words: Diabetic nephropathy, Diabetic retinopathy, Type 1diabetes, Microalbuminuria, Fundus photography

Retinopathy and glomerulopathy are among the most severe complications of type 1 diabetes. Retinopathy is relatively common in early onset diabetes. The best screening method for diabetic retinopathy is stereoscopic color fundus photography. Microalbuminuria, as defined by urinary escretion of albumin in 2 out of 3 24-hours urine samples, is the best screening method for the screening of early stages of diabetic nephropathy. It should be accompanied by periodical blood pressure control. If the onset of diabetes is prepuberal, both screening should be started not later than 5 years from the onset, and anyway when the patient is 11 years old, then it should be repeated every year. If the onset of diabetes is after puberty has started, the screening is recommended 2 years after onset, then every year. Abnormal screening findings should always prompt a revision of the case-management strategy.